Applications · health medicine

Protein language models (pLMs) are powerful predictors of protein structure and function, learning through unsupervised training on millions of protein sequences. pLMs are thought to capture common motifs in protein sequences, but the specifics of pLM features are not well understood. Identifying these features would not only shed light on how pLMs work, but potentially uncover novel protein biology––studying the model to study the biology. Motivated by this, we train sparse autoencoders (SAEs) on the residual stream of a pLM, ESM-2. By characterizing SAE features, we determine that pLMs use a combination of generic features and family-specific features to represent a protein. In addition, we demonstrate how known sequence determinants of properties such as thermostability and subcellular localization can be identified by linear probing of SAE features. For predictive features without known functional associations, we hypothesize their role in unknown mechanisms and provide visualization tools to aid their interpretation. Our study gives a better understanding of the limitations of pLMs, and demonstrates how SAE features can be used to help generate hypotheses for biological mechanisms. We release our code, model weights, and feature visualizer.

Current screening programs that focus on improving patient health while minimizing screening costs are tailored for individual diseases. Designing unified screening programs for multiple diseases requires carefully balancing competing disease risks, which is an open problem. In this work, we address this problem by casting unified screening as a referral problem, in which we choose to activate a subset of screening policies for individual diseases by accounting for competing risks that influence patient outcomes. We introduce a novel optimization framework that incorporates disease risks, budget constraints, and diagnostic error limits and characterize the structural properties of the optimal referral policy. For the unified screening of two diseases, we show that the optimal activation threshold for the screening of one disease depends on the risk of the other, resulting in decision boundaries with distinct risk-dependent profiles. We compare our unified model with independent screening programs that apply isolated activation thresholds for screening of each disease. Our approach optimizes screening decisions collectively, improving overall survival outcomes, particularly for patients with high disease risks.

We introduce Pallatom, an innovative protein generation model capable of producing protein structures with all-atom coordinates. Pallatom directly learns and models the joint distribution $P(\textit{structure}, \textit{seq})$ by focusing on $P(\textit{all-atom})$, effectively addressing the interdependence between sequence and structure in protein generation. To achieve this, we propose a novel network architecture specifically designed for all-atom protein generation. Our model employs a dual-track framework that tokenizes proteins into token-level and atomic-level representations, integrating them through a multi-layer decoding process with "traversing" representations and recycling mechanism. We also introduce the $\texttt{atom14}$ representation method, which unifies the description of unknown side-chain coordinates, ensuring high fidelity between the generated all-atom conformation and its physical structure. Experimental results demonstrate that Pallatom excels in key metrics of protein design, including designability, diversity, and novelty, showing significant improvements across the board. Our model not only enhances the accuracy of protein generation but also exhibits excellent sampling efficiency, paving the way for future applications in larger and more complex systems.

Understanding cellular responses to stimuli is crucial for biological discovery and drug development. Transcriptomics provides interpretable, gene-level insights, while microscopy imaging offers rich predictive features but is harder to interpret. Weakly paired datasets, where samples share biological states, enable multimodal learning but are scarce, limiting their utility for training and multimodal inference. We propose a framework to enhance transcriptomics by distilling knowledge from microscopy images. Using weakly paired data, our method aligns and binds modalities, enriching gene expression representations with morphological information. To address data scarcity, we introduce (1) *Semi-Clipped*, an adaptation of CLIP for cross-modal distillation using pretrained foundation models, achieving state-of-the-art results, and (2) *PEA* (**P**erturbation **E**mbedding **A**ugmentation), a novel augmentation technique that enhances transcriptomics data while preserving inherent biological information. These strategies improve the predictive power and retain the interpretability of transcriptomics, enabling rich unimodal representations for complex biological tasks.

Medical Visual Question Answering (MVQA) requires AI models to answer questions related to medical images, offering significant potential to assist medical professionals in evaluating and diagnosing diseases, thereby improving early interventions. However, existing MVQA datasets primarily focus on basic questions regarding visual perception and pattern recognition, without addressing the more complex questions that are critical in clinical diagnosis and decision-making. This paper introduces a new benchmark designed for professional-level medical reasoning, simulating the decision-making process. We achieve this by collecting MRI and clinical data related to Hypoxic-Ischemic Encephalopathy, enriched with expert annotations and insights. Building on this data, we generate clinical question-answer pairs and MRI interpretations to enable comprehensive diagnosis, interpretation, and prediction of neurocognitive outcomes. Our evaluation of current large vision-language models (LVLMs) shows limited performance on this benchmark, highlighting both the challenges of the task and the importance of this benchmark for advancing medical AI. Furthermore, we propose a novel ``Clinical Graph of Thoughts" model, which integrates domain-specific medical knowledge and clinical reasoning processes with the interpretive abilities of LVLMs. The model demonstrates promising results, achieving around 15\% absolute gain on the most important neurocognitive outcome task, while the benchmark still reveals substantial opportunities for further research innovation.

*In silico* modeling of transcriptional responses to perturbations is crucial for advancing our understanding of cellular processes and disease mechanisms. We present PertEval-scFM, a standardized framework designed to evaluate models for perturbation effect prediction. We apply PertEval-scFM to benchmark zero-shot single-cell foundation model (scFM) embeddings against baseline models to assess whether these contextualized representations enhance perturbation effect prediction. Our results show that scFM embeddings offer limited improvement over simple baseline models in the zero-shot setting, particularly under distribution shift. Overall, this study provides a systematic evaluation of zero-shot scFM embeddings for perturbation effect prediction, highlighting the challenges of this task and the limitations of current-generation scFMs. Our findings underscore the need for specialized models and high-quality datasets that capture a broader range of cellular states. Source code and documentation can be found at: https://github.com/aaronwtr/PertEval.

Whole Slide Image (WSI) analysis is framed as a Multiple Instance Learning (MIL) problem, but existing methods struggle with non-stackable data due to inconsistent instance lengths, which degrades performance and efficiency. We propose a Distributed Parallel Gradient Stacking (DPGS) framework with Deep Model-Gradient Compression (DMGC) to address this. DPGS enables lossless MIL data stacking for the first time, while DMGC accelerates distributed training via joint gradient-model compression. Experiments on Camelyon16 and TCGA-Lung datasets demonstrate up to 31× faster training, up to a 99.2% reduction in model communication size at convergence, and up to a 9.3% improvement in accuracy compared to the baseline. To our knowledge, this is the first work to solve non-stackable data in MIL while improving both speed and accuracy.

Deriving insights from experimentally generated datasets requires methods that can account for random and systematic measurement errors and remove them in order to accurately represent the underlying effects of the conditions being tested. Here we present a framework for pretraining on large-scale microscopy datasets that includes three steps: (1) curating a set of diverse and self-consistent training samples, (2) scaling training of an appropriate foundation model architecture on this dataset, (3) evaluating intermediate layers of the trained model to identify the best representation for downstream tasks. Using this strategy, we present the largest foundation model for cell microscopy data to our knowledge, a new 1.9 billion-parameter ViT-G/8 MAE trained on over 8 billion microscopy image crops. Compared to a previous published ViT-L/8 MAE, our new model achieves a 60\% improvement in linear separability of genetic perturbations and obtains the best overall performance on whole-genome relationship recall, batch correction replicate consistency, and compound-gene activity prediction benchmarks.

Medical AI models excel at tumor detection and segmentation. However, their latent representations often lack explicit ties to clinical semantics, producing outputs less trusted in clinical practice. Most of the existing models generate either segmentation masks/labels (localizing where without why) or textual justifications (explaining why without where), failing to ground clinical concepts in spatially localized evidence. To bridge this gap, we propose to develop models that can justify the segmentation or detection using clinically relevant terms and point to visual evidence. We address two core challenges: First, we curate a rationale dataset to tackle the lack of paired images, annotations, and textual rationales for training. The dataset includes 180K image-mask-rationale triples with quality evaluated by expert radiologists. Second, we design rationale-informed optimization that disentangles and localizes fine-grained clinical concepts in a self-supervised manner without requiring pixel-level concept annotations. Experiments across medical benchmarks show our model demonstrates superior performance in segmentation, detection, and beyond. The anonymous link to our code.

Inspired by the success of unsupervised pre-training paradigms, researchers have applied these approaches to DNA pre-training. However, we argue that these approaches alone yield suboptimal results because pure DNA sequences lack sufficient information, since their functions are regulated by genomic profiles like chromatin accessibility. Here, we demonstrate that supervised training for genomic profile prediction serves as a more effective alternative to pure sequence pre-training. Furthermore, considering the multi-species and multi-profile nature of genomic profile prediction, we introduce our **S**pecies-**P**rofile **A**daptive **C**ollaborative **E**xperts (SPACE) that leverages Mixture of Experts (MoE) to better capture the relationships between DNA sequences across different species and genomic profiles, thereby learning more effective DNA representations. Through extensive experiments across various tasks, our model achieves state-of-the-art performance, establishing that DNA models trained with supervised genomic profiles serve as powerful DNA representation learners.

Recent years have witnessed a surge in the development of protein structural tokenization methods, which chunk protein 3D structures into discrete or continuous representations. Structure tokenization enables the direct application of powerful techniques like language modeling for protein structures, and large multimodal models to integrate structures with protein sequences and functional texts. Despite the progress, the capabilities and limitations of these methods remain poorly understood due to the lack of a unified evaluation framework. We first introduce **StructTokenBench**, a framework that comprehensively evaluates the quality and efficiency of structure tokenizers, focusing on fine-grained local substructures rather than global structures, as typical in existing benchmarks. Our evaluations reveal that no single model dominates all benchmarking perspectives. Observations of codebook under-utilization led us to develop **AminoAseed**, a simple yet effective strategy that enhances codebook gradient updates and optimally balances codebook size and dimension for improved tokenizer utilization and quality. Compared to the leading model ESM3, our method achieves an average of 6.31\% performance improvement across 24 supervised tasks, with sensitivity and utilization rates increased by 12.83\% and 124.03\%, respectively. Source code and model weights are available at https://github.com/KatarinaYuan/StructTokenBench.

The accurate interpretation of Electrocardiogram (ECG) signals is pivotal for diagnosing cardiovascular diseases. Integrating ECG signals with accompanying textual reports further holds immense potential to enhance clinical diagnostics by combining physiological data and qualitative insights. However, this integration faces significant challenges due to inherent modality disparities and the scarcity of labeled data for robust cross-modal learning. To address these obstacles, we propose D-BETA, a novel framework that pre-trains ECG and text data using a contrastive masked auto-encoder architecture, uniquely combining generative and boosted discriminative capabilities for robust cross-modal representations. This is accomplished through masked modality modeling, specialized loss functions, and an improved negative sampling strategy tailored for cross-modal alignment. Extensive experiments on five public datasets across diverse downstream tasks demonstrate that D-BETA significantly outperforms existing methods, achieving an average AUC improvement of 15% in linear probing with only one percent of training data and 2% in zero-shot performance without requiring training data over state-of-the-art models. These results highlight the effectiveness of D-BETA, underscoring its potential to advance automated clinical diagnostics through multi-modal representations.

Algorithms for machine learning-guided design, or *design algorithms*, use machine learning-based predictions to propose novel objects with desired property values. Given a new design task—for example, to design novel proteins with high binding affinity to a therapeutic target—one must choose a design algorithm and specify any hyperparameters and predictive and/or generative models involved. How can these decisions be made such that the resulting designs are successful? This paper proposes a method for *design algorithm selection*, which aims to select design algorithms that will produce a distribution of design labels satisfying a user-specified success criterion—for example, that at least ten percent of designs’ labels exceed a threshold. It does so by combining designs’ predicted property values with held-out labeled data to reliably forecast characteristics of the label distributions produced by different design algorithms, building upon techniques from prediction-powered inference (Angelopoulos et al., 2023). The method is guaranteed with high probability to return design algorithms that yield successful label distributions (or the null set if none exist), if the density ratios between the design and labeled data distributions are known. We demonstrate the method’s effectiveness in simulated protein and RNA design tasks, in settings with either known or estimated density ratios.

Self-supervised learning (SSL) has proven to be a powerful approach for extracting biologically meaningful representations from single-cell data. To advance our understanding of SSL methods applied to single-cell data, we present scSSL-Bench, a comprehensive benchmark that evaluates nineteen SSL methods. Our evaluation spans nine datasets and focuses on three common downstream tasks: batch correction, cell type annotation, and missing modality prediction. Furthermore, we systematically assess various data augmentation strategies. Our analysis reveals task-specific trade-offs: the specialized single-cell frameworks, scVI, CLAIRE, and the finetuned scGPT excel at uni-modal batch correction, while generic SSL methods, such as VICReg and SimCLR, demonstrate superior performance in cell typing and multi-modal data integration. Random masking emerges as the most effective augmentation technique across all tasks, surpassing domain-specific augmentations. Notably, our results indicate the need for a specialized single-cell multi-modal data integration framework. scSSL-Bench provides a standardized evaluation platform and concrete recommendations for applying SSL to single-cell analysis, advancing the convergence of deep learning and single-cell genomics.

Proteolysis-targeting chimeras (PROTACs) are a groundbreaking technology for targeted protein degradation, but designing effective linkers that connect two molecular fragments to form a drug-candidate PROTAC molecule remains a key challenge. While diffusion models show promise in molecular generation, current diffusion models for PROTAC linker design are typically trained on small molecule datasets, introducing distribution mismatches in the chemical space between small molecules and target PROTACs. Direct fine-tuning on limited PROTAC datasets often results in overfitting and poor generalization. In this work, we propose DAD-PROTAC, a domain-adapted diffusion model for PROTAC linker design, which addresses this distribution mismatch in chemical space through density ratio estimation to bridge the gap between small-molecule and PROTAC domains. By decomposing the target score estimator into a pre-trained score function and a lightweight score correction term, DAD-PROTAC achieves efficient fine-tuning without full retraining. Experimental results demonstrate its superior ability to generate high-quality PROTAC linkers.

Spatially Resolved Transcriptomics (SRT) is a cutting-edge technique that captures the spatial context of cells within tissues, enabling the study of complex biological networks. Recent graph-based methods leverage both gene expression and spatial information to identify relevant spatial domains. However, these approaches fall short in obtaining meaningful spot representations, especially for spots near spatial domain boundaries, as they heavily emphasize adjacent spots that have minimal feature differences from an anchor node. To address this, we propose Spotscape, a novel framework that introduces the Similarity Telescope module to capture global relationships between multiple spots. Additionally, we propose a similarity scaling strategy to regulate the distances between intra- and inter-slice spots, facilitating effective multi-slice integration. Extensive experiments demonstrate the superiority of Spotscape in various downstream tasks, including single-slice and multi-slice scenarios.

Language Models (LMs) have advanced diagnosis prediction by leveraging the semantic understanding of medical concepts in Electronic Health Records (EHRs). Despite these advancements, existing LM-based methods often fail to capture the structures of medical concepts (e.g., hierarchy structure from domain knowledge). In this paper, we propose BoxLM, a novel framework that unifies the structures and semantics of medical concepts for diagnosis prediction. Specifically, we propose a structure-semantic fusion mechanism via box embeddings, which integrates both ontology-driven and EHR-driven hierarchical structures with LM-based semantic embeddings, enabling interpretable medical concept representations. Furthermore, in the box-aware diagnosis prediction module, an evolve-and-memorize patient box learning mechanism is proposed to model the temporal dynamics of patient visits, and a volume-based similarity measurement is proposed to enable accurate diagnosis prediction. Extensive experiments demonstrate that BoxLM consistently outperforms state-of-the-art baselines, especially achieving strong performance in few-shot learning scenarios, showcasing its practical utility in real-world clinical settings.

Multiple Instance Learning (MIL) is a cornerstone approach in computational pathology for distilling embeddings from gigapixel tissue images into patient-level representations to predict clinical outcomes. However, MIL is frequently challenged by the constraints of working with small, weakly-supervised clinical datasets. Unlike fields such as natural language processing and computer vision, which effectively use transfer learning to improve model quality in data-scarce environments, the transferability of MIL models remains largely unexplored. We conduct the first comprehensive investigation into transfer learning capabilities of pretrained MIL models, evaluating 11 MIL models across 19 pretraining tasks spanning tissue subtyping, cancer grading, and molecular subtype prediction. We observe a substantial performance boost with finetuning pretrained models over training from randomly initialized weights, even with domain differences between pretraining and target tasks. Pretraining on pan-cancer datasets enables consistent generalization across organs and task types compared to single-disease pretraining. Remarkably, this pan-cancer pretraining leads to better transfer than that of a state-of-the-art slide-level foundation model, while using only 6.5\% of the training data. These findings indicate that MIL architectures exhibit robust adaptability, offering insights into the benefits of leveraging pretrained models to enhance performance in computational pathology.

Electrocardiograms (ECGs) play a vital role in monitoring cardiac health and diagnosing heart diseases. However, traditional deep learning approaches for ECG analysis rely heavily on large-scale manual annotations, which are both time-consuming and resource-intensive to obtain. To overcome this limitation, self-supervised learning (SSL) has emerged as a promising alternative, enabling the extraction of robust ECG representations that can be efficiently transferred to various downstream tasks. While previous studies have explored SSL for ECG pretraining and multi-modal ECG-language alignment, they often fail to capture the multi-scale nature of ECG signals. As a result, these methods struggle to learn generalized representations due to their inability to model the hierarchical structure of ECG data. To address this gap, we introduce MELP, a novel Multi-scale ECG-Language Pretraining (MELP) model that fully leverages hierarchical supervision from ECG-text pairs. MELP first pretrains a cardiology-specific language model to enhance its understanding of clinical text. It then applies three levels of cross-modal supervision—at the token, beat, and rhythm levels—to align ECG signals with textual reports, capturing structured information across different time scales. We evaluate MELP on three public ECG datasets across multiple tasks, including zero-shot ECG classification, linear probing, and transfer learning. Experimental results demonstrate that MELP outperforms existing SSL methods, underscoring its effectiveness and adaptability across diverse clinical applications. Our code is available at https://github.com/HKU-MedAI/MELP.

The goal of protein fitness optimization is to discover new protein variants with enhanced fitness for a given use. The vast search space and the sparsely populated fitness landscape, along with the discrete nature of protein sequences, pose significant challenges when trying to determine the gradient towards configurations with higher fitness. We introduce *Variational Latent Generative Protein Optimization* (VLGPO), a variational perspective on fitness optimization. Our method embeds protein sequences in a continuous latent space to enable efficient sampling from the fitness distribution and combines a (learned) flow matching prior over sequence mutations with a fitness predictor to guide optimization towards sequences with high fitness. VLGPO achieves state-of-the-art results on two different protein benchmarks of varying complexity. Moreover, the variational design with explicit prior and likelihood functions offers a flexible plug-and-play framework that can be easily customized to suit various protein design tasks.